By Jordan Bourque
On June 5, 2020, the Veterinary Medical Board (VMB) published notice of its intent to amend sections 2032.15 and 2032.25, Title 16 of the California Code of Regulations, to clarify the meaning of veterinarian-client-patient relationships (VCPRs), which are set forth in the proposed language. According to the notice, by amending and adopting the proposed regulations, the Board seeks to ensure that California consumers and their animals are protected by being provided with veterinary services when in need, and by ensuring proper prescribing, treating, and documentation protocols.
According to the Initial Statement of Reasons, current regulations provide that it is unprofessional conduct for a veterinarian to prescribe or furnish a drug or treatment for the prevention, cure, or relief of an animal’s injury or disease without first establishing a VCPR. After the current regulations were in place in 2014, VMB started discussions about whether a designated veterinarian could establish a VCPR and safely diagnose and treat animals through telemedicine. Under current law, a veterinarian must examine an animal patient in person to determine the appropriate diagnosis and treatment. This is because animal patients are unable to communicate to the veterinarian their symptoms, thus diagnosing and treating solely on the basis of the client’s observations of the animal is insufficient to properly diagnose and treat the animal. Additionally, questions were raised regarding the circumstances under which a designated veterinarian could refill a prescription based on the originating veterinarian’s diagnosis and treatment plan.
In the proposed language, the Board has struck a balance so that telemedicine can be utilized within an existing VCPR. VMB proposes to amend section 2032.14(a) to establish that, in the absence of the original veterinarian, the VCPR may continue to exist in the absence of client communication when the designated veterinarian works at the same location where the medical files are kept. In amending section 2032.25(b)(1), the Board seeks to clarify that a veterinarian may serve in the absence of the treating veterinarian and prescribe, dispense, or furnish drugs on an emergency basis for a traveling patient only as necessary to maintain the health of the animal until they can return to the originally treating veterinarian. However, the veterinarian must make a reasonable effort to contact the original prescribing veterinarian and document in the medical record the communication or attempt to contact the prescribing veterinarian. Further, the Board seeks to amend section 2032.25(b) to authorize the veterinarian to prescribe, dispense, or furnish a drug to an animal patient when the original prescribing veterinarian is absent and the veterinarian authorizing the refill is in the same practice as the original prescribing veterinarian and has reviewed the patient records.
On July 20, 2020, the 45-day public comment period ended. At the Board’s October 22, 2020 meeting, members reviewed public comments consisting of two letters in support and one letter in support with conditions. The letter of support with conditions raised concern with statements made in the initial statement of reasons, specifically that the proposal may affect future legislation or Board regulation that may authorize a California licensed veterinarian to refer an animal patient to a qualified physical therapist to perform animal rehabilitation services under indirect supervision at another location. The Board considered a proposed response to incorporate into the Final Statement of Reasons. Further, the Board considered proposed modified text and issuance of another 15-day public comment period.